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Updated: Sep 14, 2025

Author Spotlight: Recent Advancements in Reoperative Foregut Surgery
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Tips for revisional antireflux surgery.

Vic Velanovich1

  • 1Department of Surgery, Morsani College of Medicine, University of South Florida, Tampa, FL, United States.

Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract
|July 24, 2025
PubMed
Summary
This summary is machine-generated.

Antireflux surgery can fail in various ways, including recurrent heartburn, dysphagia, hiatal hernia, and bloating. Each case requires an individualized approach for successful management and optimal patient outcomes.

Keywords:
Antireflux surgery failureBloatingDysphagiaHeartburnHiatal hernia

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Area of Science:

  • Gastroenterology
  • Surgical Outcomes

Background:

  • Failure of antireflux operations presents diverse challenges for surgeons.
  • Common failure types include recurrent heartburn, dysphagia, hiatal hernia, and bloating.

Purpose of the Study:

  • To outline a personalized approach to managing common failures after antireflux surgery.
  • To provide insights based on extensive clinical experience.

Main Methods:

  • Review of personal experience spanning over 30 years in antireflux and hiatal hernia surgery.
  • Focused study on the management of postoperative complications.

Main Results:

  • Individualized assessment is crucial for each failure type.
  • Recurrent heartburn necessitates evaluation for pathologic reflux; surgery choice must be tailored.
  • Postoperative dysphagia may stem from inadequate preoperative assessment, sometimes requiring reoperation.
  • "Recurrent" hiatal hernias may indicate disease progression, requiring management of pressure gradients and tissue strength.
  • Postoperative bloating can be multifactorial; pyloric drainage may help delayed gastric emptying.

Conclusions:

  • Antireflux surgery failure is complex and patient-specific.
  • Surgeons need a broad skill set to address diverse postoperative issues effectively.